tbuckley/cabot-search huggingface dataset:
Effectiveness of holistic assessment-based interventions for adults with multiple long-term conditions and frailty: an umbrella review of systematic reviews
Authors: Stella Arakelyan, Nataysia Mikula-Noble, Leonard Ho, Nazir Lone, Atul Anand, Marcus J Lyall, Stewart W Mercer, Bruce Guthrie
Journal: The Lancet Healthy Longevity (2023)

Holistic assessment-based interventions (HABIs) are effective in older people admitted to hospital, but it is unclear whether similar interventions are effective in adults with multiple long-term conditions or frailty in the community. We conducted an umbrella review to comprehensively evaluate the literature on HABIs for adults (aged ≥18 years) with multiple long-term conditions, and frailty. We searched eight databases for systematic reviews reporting on experimental or quasi-experimental studies. Of 9803 titles screened, we identified 29 eligible reviews (14 with meta-analysis) reporting on 14 types of HABIs. The evidence for the effectiveness of HABIs was largely inconsistent across different types of interventions, settings, and outcomes. We found evidence of no benefit from hospital HABIs on health-related quality of life (HRQoL) and emergency department re-attendance, and evidence of no benefit from community HABIs on overall health-care utilisation rates, emergency department attendance, nursing home admissions, and mortality. The best evidence of effectiveness was for hospital comprehensive geriatric assessment (CGA) on nursing home admissions, keeping patients alive and in their own homes. There was some evidence of benefit from community CGA on hospital admissions, and from CGA spanning community and hospital settings on HRQoL. Patient-centred medical homes had beneficial effects on HRQoL, mental health, self-management, and hospital admissions.
Determinants of passive antibody efficacy in SARS-CoV-2 infection: a systematic review and meta-analysis
Authors: Eva Stadler, Khai Li Chai, Timothy E Schlub, Deborah Cromer, Shanchita R Khan, Mark N Polizzotto, Stephen J Kent, Claire Beecher, Heath White, Tari Turner, Nicole Skoetz, Lise Estcourt, Zoe K McQuilten, Erica M Wood, David S Khoury, Miles P Davenport
Journal: The Lancet Microbe (2023)

BackgroundRandomised controlled trials of passive antibodies as treatment and prophylaxis for COVID-19 have reported variable efficacy. However, the determinants of efficacy have not been identified. We aimed to assess how the dose and timing of administration affect treatment outcome.MethodsIn this systematic review and meta-analysis, we extracted data from published studies of passive antibody treatment from Jan 1, 2019, to Jan 31, 2023, that were identified by searching multiple databases, including MEDLINE, PubMed, and ClinicalTrials.gov. We included only randomised controlled trials of passive antibody administration for the prevention or treatment of COVID-19. To compare administered antibody dose between different treatments, we used data on in-vitro neutralisation titres to normalise dose by antibody potency. We used mixed-effects regression and model fitting to analyse the relationship between timing, dose and efficacy.FindingsWe found 58 randomised controlled trials that investigated passive antibody therapies for the treatment or prevention of COVID-19. Earlier clinical stage at treatment initiation was highly predictive of the efficacy of both monoclonal antibodies (p<0·0001) and convalescent plasma therapy (p=0·030) in preventing progression to subsequent stages, with either prophylaxis or treatment in outpatients showing the greatest effects. For the treatment of outpatients with COVID-19, we found a significant association between the dose administered and efficacy in preventing hospitalisation (relative risk 0·77; p<0·0001). Using this relationship, we predicted that no approved monoclonal antibody was expected to provide more than 30% efficacy against some omicron (B.1.1.529) subvariants, such as BQ.1.1.InterpretationEarly administration before hospitalisation and sufficient doses of passive antibody therapy are crucial to achieving high efficacy in preventing clinical progression. The relationship between dose and efficacy provides a framework for the rational assessment of future passive antibody prophylaxis and treatment strategies for COVID-19.FundingThe Australian Government Department of Health, Medical Research Future Fund, National Health and Medical Research Council, the University of New South Wales, Monash University, Haematology Society of Australia and New Zealand, Leukaemia Foundation, and the Victorian Government.
AMR is more complicated than a lack of drugs
Authors: None The Lancet Microbe
Journal: The Lancet Microbe (2023)

Later this month (Nov 18–24) is World AMR Awareness Week (WAAW), the annual reminder of this long smouldering crisis in modern health care. This is the first year with the new name as it was formerly World Antimicrobial Awareness Week, but it was felt that the name needed to highlight that resistance is the focus. The WAAW campaign emphasises a positive message of promoting best practices to reduce the emergence and spread of drug-resistant infections, and so the theme this year is a repeat of 2022's theme: preventing antimicrobial resistance together.
Association of neurocognitive disorders with morbidity and mortality in older adults undergoing major surgery in the USA: a retrospective, population-based, cohort study
Authors: Alexander T Abess, Stacie G Deiner, Alexandra Briggs, Elizabeth L Whitlock, Kristin E Charette, Vinca W Chow, Shahzad Shaefi, Pablo Martinez-Camblor, Alistair James O'Malley, Myles Dustin Boone
Journal: The Lancet Healthy Longevity (2023)

BackgroundNeurocognitive disorders become increasingly common as patients age, and increasing numbers of surgical interventions are done on older patients. The aim of this study was to understand the clinical characteristics and outcomes of surgical patients with neurocognitive disorders in the USA in order to guide future targeted interventions for better care.MethodsThis retrospective cohort study used claims data for US Medicare beneficiaries aged 65 years and older with a record of inpatient admission for a major diagnostic or therapeutic surgical procedure between Jan 1, 2017, and Dec 31, 2018. Data were retrieved through a data use agreement between Dartmouth Hitchcock Medical Center and US Centers for Medicare and Medicaid Services via the Research Data Assistance Center. The exposure of interest was the presence of a pre-existing neurocognitive disorder as defined by diagnostic code within 3 years of index hospital admission. The primary outcome was mortality at 30 days, 90 days, and 365 days from date of surgery among all patients with available data.FindingsAmong 5 263 264 Medicare patients who underwent a major surgical procedure, 767 830 (14·59%) had a pre-existing neurocognitive disorder and 4 495 434 (85·41%) had no pre-existing neurocognitive disorder. Adjusting for demographic factors and comorbidities, patients with a neurocognitive disorder had higher 30-day (hazard ratio 1·24 [95% CI 1·23–1·25]; p<0·0001), 90-day (1·25 [1·24–1·26]; p<0·0001), and 365-day mortality (1·25 [1·25–1·26]; p<0·0001) compared with patients without a neurocognitive disorder.InterpretationOur findings suggest that the presence of a neurocognitive disorder is independently associated with an increased risk of mortality. Identification of a neurocognitive disorder before surgery can help clinicians to better disclose risks and plan for patient care after hospital discharge.FundingDepartment of Anesthesiology and Perioperative Medicine at Dartmouth Hitchcock Medical Center.
Evaluation of clinical benefits of treatments for Alzheimer's disease
Authors: Kathy Y Liu, Sebastian Walsh, Carol Brayne, Richard Merrick, Edo Richard, Robert Howard
Journal: The Lancet Healthy Longevity (2023)

The need for regulatory approval of new therapies for the treatment of Alzheimer's disease—a progressive neurodegenerative condition—has made the assessment of treatment efficacy an urgent priority for discussion and investigation in the field. In the first part of this Personal View, we summarise current views on what constitutes a clinically meaningful benefit from treatment for Alzheimer's disease, including the concept of a minimum treatment effect against which to compare trial outcomes and its limitations. Considering existing and divergent definitions of clinically meaningful change, we define this concept in the second part of the Personal View by proposing a new approach that consecutively considers whether a treatment benefit for Alzheimer's disease is noticeable, valuable, and worthwhile in the context of costs and risks. This approach could be a useful foundation from which the field can move forwards on this issue and address existing gaps in understanding.
Tackling antimicrobial resistance to protect healthy ageing
Authors: None The Lancet Healthy Longevity
Journal: The Lancet Healthy Longevity (2023)

World Antimicrobial Awareness Week is observed annually from Nov 18–24 and aims to spotlight the increasing public health threat posed by antimicrobial resistance. In 2019, 1·27 million people globally died as a direct result of antimicrobial resistance. Additionally, the high rates of hospital admissions and prolonged hospital stays, as well as functional decline in patients, resulting from antibiotic-resistant infections threaten the stability of health-care systems and economies. Therefore, addressing antimicrobial resistance requires immediate action.
Immune responses to SARS-CoV-2 mRNA vaccination in people with idiopathic CD4 lymphopenia
Authors: Joseph M. Rocco, Kristin L. Boswell, Elizabeth Laidlaw, Brian Epling, Megan Anderson, Leonid Serebryannyy, Sandeep Narpala, Sarah O’Connell, Heather Kalish, Sophie Kelly, Sarah Porche, Cihan Oguz, Adrian McDermott, Maura Manion, Richard A. Koup, Andrea Lisco, Irini Sereti
Journal: Journal of Allergy and Clinical Immunology (2023)
Association of mild chronic obstructive pulmonary disease with all-cause mortality: A systematic review and meta-analysis
Authors: Weifeng Zou, Jie Ou, Fan Wu, Huanhuan Fan, Yuyan Hou, Haiqing Li, Zhishan Deng, Shuling Liu, Jinxing Hu, Pixin Ran
Journal: Pulmonology (2023)

It is unclear whether patients with Global Initiative for Chronic Obstructive Lung Disease stage 1 (mild) chronic obstructive pulmonary disease (COPD) have worse respiratory outcomes than individuals with normal spirometry. For this systematic review and meta-analysis, we conducted a search of PubMed, Embase, and Web of Science for all literature published up to 1 March 2023. Studies comparing mortality between mild COPD and normal spirometry were included. A random-effects model was used to estimate the combined effect size and its 95% confidence interval (CI). The primary outcome was all-cause mortality. Respiratory disease-related mortality were examined as secondary outcomes. Of 5242 titles identified, 12 publications were included. Patients with mild COPD had a higher risk of all-cause mortality than individuals with normal spirometry (pre-bronchodilator: hazard ratio [HR] = 1.21, 95% CI: 1.11–1.32, I2 = 47.1%; post-bronchodilator: HR = 1.19, 95% CI: 1.02–1.39, I2 = 0.0%). Funnel plots showed a symmetrical distribution of studies and did not suggest publication bias. In jackknife sensitivity analyses, the increased risk of all-cause mortality remained consistent for mild COPD. When the meta-analysis was repeated and one study was omitted each time, the HR and corresponding 95% CI were >1. Patients with mild COPD also had a higher risk of respiratory disease-related mortality (HR = 1.71, 95% CI: 1.03–2.82, I2 = 0.0%). Our results suggest that mild COPD is associated with increased all-cause mortality and respiratory disease-related mortality compared with normal spirometry. Further research is required to determine whether early intervention and treatment are beneficial in mild COPD.
Patterns and practices of parenting transgender children: A brief Comparative study
Authors: Fernando González-González, Inmaculada Fernández-Agis
Journal: International Journal of Transgender Health (2023)

The practices of parents raising children with trans* life experiences influence their subsequent social adjustment. The aim of the study was to identify potential differences in parenting patterns and practices between two groups, one comprising families with transgender children and the other group comprising families with cisgender children. Twenty-eight adults and 15 children and adolescents from Bogotá, Colombia, participated. We performed descriptive, nonparametric comparative, and Bayesian comparative analyses for independent samples. We used a frequentist inferential comparative method with the Mann–Whitney U test with an effect size based on rank-biserial correlation, which revealed no statistically significant difference values. Bayesian comparisons showed minimal evidence in favor of the null hypothesis in all comparisons performed, except for the Behavioral Control or Regulation variable. The main finding of this study suggests that parents of children with trans* life experiences may not be addressing their specific needs, which could lead to a lack of understanding of their situation and support in their transition process.
Genetically engineered M2-like macrophage-derived exosomes for P. gingivalis-suppressed cementum regeneration: From mechanism to therapy
Authors: Xin Huang, Yifei Deng, Junhong Xiao, Huiyi Wang, Qiudong Yang, Zhengguo Cao
Journal: Bioactive Materials (2023)

Cementum, a thin layer of mineralized tissue covering tooth root surface, is recognized as the golden standard in periodontal regeneration. However, current efforts mainly focus on alveolar bone regeneration rather than cementum regeneration, and rarely take Porphyromonas gingivalis (Pg), the keystone pathogen responsible for periodontal tissue destruction, into consideration. Though M2 macrophage-derived exosomes (M2-EXO) show promise in tissue regeneration, the exosome-producing M2 macrophages are induced by exogenous cytokines with transitory and unstable effects, restricting the regeneration potential of M2-EXO. Here, exosomes derived from genetically engineered M2-like macrophages are constructed by silencing of casein kinase 2 interacting protein-1 (Ckip-1), a versatile player involved in various biological processes. Ckip-1 silencing is proved to be an effective gene regulation strategy to obtain permanent M2-like macrophages with mineralization-promoting effect. Further, exosomes derived from Ckip-1-silenced macrophages (sh-Ckip-1-EXO) rescue Pg-suppressed cementoblast mineralization and cementogenesis. Mechanismly, sh-Ckip-1-EXO delivers Let-7f-5p targeting and silencing Ckip-1, a negative regulator also for cementum formation and cementoblast mineralization. More deeply, downregulation of Ckip-1 in cementoblasts by exosomal Let-7f-5p activates PGC-1α-dependent mitochondrial biogenesis. In all, this study provides a new strategy of genetically engineered M2-like macrophage-derived exosomes for cementum regeneration under Pg-dominated inflammation.
Smart chemistry for traceless release of anticancer therapeutics
Authors: Céline Jasmin Prange, Xile Hu, Li Tang
Journal: Biomaterials (2023)

In the design of delivery strategies for anticancer therapeutics, the controlled release of intact cargo at the destined tumor and metastasis locations is of particular importance. To this end, stimuli-responsive chemical linkers have been extensively investigated owing to their ability to respond to tumor-specific physiological stimuli, such as lowered pH, altered redox conditions, increased radical oxygen species and pathological enzymatic activities. To prevent premature action and off-target effects, anticancer therapeutics are chemically modified to be transiently inactivated, a strategy known as prodrug development. Prodrugs are reactivated upon stimuli-dependent release at the sites of interest. As most drugs and therapeutic proteins have the optimal activity when released from carriers in their native and original forms, traceless release mechanisms are increasingly investigated. In this review, we summarize the chemical toolkit for developing innovative traceless prodrug strategies for stimuli-responsive drug delivery and discuss the applications of these chemical modifications in anticancer treatment including cancer immunotherapy.
Targeted transplantation of engineered mitochondrial compound promotes functional recovery after spinal cord injury by enhancing macrophage phagocytosis
Authors: Jiaqi Xu, Chaoran Shi, Feifei Yuan, Yinghe Ding, Yong Xie, Yudong Liu, Fengzhang Zhu, Hongbin Lu, Chunyue Duan, Jianzhong Hu, Liyuan Jiang
Journal: Bioactive Materials (2023)

Mitochondria are crucial in sustaining and orchestrating cellular functions. Capitalizing on this, we explored mitochondrial transplantation as an innovative therapeutic strategy for acute spinal cord injury (SCI). In our study, we developed an engineered mitochondrial compound tailored to target macrophages within the SCI region. Sourced from IL-10-induced Mertkhi bone marrow-derived macrophages, we conjugated a peptide sequence, cations-cysteine-alanine-glutamine-lysine (CAQK), with the mitochondria, optimizing its targeting affinity for the injury site. Our data demonstrated that these compounds significantly enhanced macrophage phagocytosis of myelin debris, curtailed lipid buildup, ameliorated mitochondrial dysfunction, and attenuated pro-inflammatory profiles in macrophages, both in vitro and in vivo. The intravenously delivered mitochondrial compounds targeted the SCI epicenter, with macrophages being the primary recipients. Critically, they promoted tissue regeneration and bolstered functional recovery in SCI mice. This study heralds a transformative approach to mitochondrial transplantation in SCI, spotlighting the modulation of macrophage activity, phagocytosis, and phenotype.
Signal domain adaptation network for limited-view optoacoustic tomography
Authors: Anna Klimovskaia Susmelj, Berkan Lafci, Firat Ozdemir, Neda Davoudi, Xosé Luís Deán-Ben, Fernando Perez-Cruz, Daniel Razansky
Journal: Medical Image Analysis (2023)

Optoacoustic (OA) imaging is based on optical excitation of biological tissues with nanosecond-duration laser pulses and detection of ultrasound (US) waves generated by thermoelastic expansion following light absorption. The image quality and fidelity of OA images critically depend on the extent of tomographic coverage provided by the US detector arrays. However, full tomographic coverage is not always possible due to experimental constraints. One major challenge concerns an efficient integration between OA and pulse-echo US measurements using the same transducer array. A common approach toward the hybridization consists in using standard linear transducer arrays, which readily results in arc-type artifacts and distorted shapes in OA images due to the limited angular coverage. Deep learning methods have been proposed to mitigate limited-view artifacts in OA reconstructions by mapping artifactual to artifact-free (ground truth) images. However, acquisition of ground truth data with full angular coverage is not always possible, particularly when using handheld probes in a clinical setting. Deep learning methods operating in the image domain are then commonly based on networks trained on simulated data. This approach is yet incapable of transferring the learned features between two domains, which results in poor performance on experimental data. Here, we propose a signal domain adaptation network (SDAN) consisting of i) a domain adaptation network to reduce the domain gap between simulated and experimental signals and ii) a sides prediction network to complement the missing signals in limited-view OA datasets acquired from a human forearm by means of a handheld linear transducer array. The proposed method showed improved performance in reducing limited-view artifacts without the need for ground truth signals from full tomographic acquisitions.
Profibrogenic macrophage-targeted delivery of mitochondrial protector via exosome formula for alleviating pulmonary fibrosis
Authors: Wei Zhang, Zhuo Wan, Di Qu, Wenqi Sun, Liang Zhang, Yuan Liang, Lei Pan, Hua Jiang, Zichen Ye, Mengying Wei, Lijun Yuan, Guodong Yang, Faguang Jin
Journal: Bioactive Materials (2023)

Pulmonary fibrosis (PF) is a devastating lung disease with limited treatment options. During this pathological process, the profibrogenic macrophage subpopulation plays a crucial role, making the characterization of this subpopulation fundamentally important. The present study revealed a positive correlation between pulmonary macrophages with higher mitochondrial mass (Mø
Pharmacist Care for Reactive Airway Disease
Authors: Amit K. Ghosh
Journal: JAMA (2003)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2024 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Higher versus lower nasal continuous positive airway pressure for extubation of extremely preterm infants in Australia (ÉCLAT): a multicentre, randomised, superiority trial
Authors: Anna M Kidman, Brett J Manley, Rosemarie A Boland, Atul Malhotra, Susan M Donath, Friederike Beker, Peter G Davis, Risha Bhatia
Journal: The Lancet Child & Adolescent Health (2023)
Pharmacist Care for Reactive Airway Disease
Authors: John A. Gans, Jenna M. Williams
Journal: JAMA (2003)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2024 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal